Saturday, October 6, 2012
What Are the Benefits of Organic Food?
A recent study from Stanford University looked at 17 studies comparing people who ate organic or conventional diets, and 223 studies comparing the bacterial, fungal or pesticide contamination of such foods. There were no long-term studies of health outcomes between the two diets in their analysis. The studies showed no consistent differences in the vitamin content of organic products, although there were higher levels of omega-3 fatty acids in organic milk. The study did find that organic produce had a 30% lower risk of pesticide contamination, but the pesticide levels in all food generally fell within the allowable safety limits. They found that children on organic diets had lower levels of pesticide residues in their urine, and organic chicken and pork reduced exposure to antibiotic resistant bacteria, but the clinical significance of all these findings were found to be unclear.
Many people have been confused by these findings from Stanford. Is organic food worth the extra money? Charles Benbrook, a professor at Washington State University’s Center for Sustaining Agriculture and Natural Resources, wrote a compelling answer in the October issue of Nutrition Action Healthletter. Benbrook has worked for the National Academy of Sciences, and consults for The Organic Center. He says that 60% of studies do show a higher nutrient content in organic foods, especially when the comparison is between fruits and vegetable grown in similar locations. The Stanford study did not consistently make such comparisons.
A recent study of tomatoes in Spain showed that organic tomatoes had twice the antioxidant levels as conventional tomatoes. There are two reasons for this. Organic plants have to fend off a range of insects, so they develop more defensive compounds that also keep us healthy. Conventional crops are produced with large amounts of nitrogen fertilizer, which drives up yields and fruit or leaf size, but dilutes the levels of vitamins, minerals and antioxidants.
Contaminants that cause food poisoning can grow more readily in conventional fields, because of extra nitrogen, and the lesser microbial diversity due to pesticide use. In organic fields there is more microbial biodiversity, so pathogens may not last as long or become as numerous.
Organic foods may not be pesticide free, because of traces blown in from conventional fields. However, pesticide levels are markedly lower. Benbrook has devised a scoring system, the Dietary Risk Index (DRI) that measures the number of different pesticide residues and their levels. Looking at organic versus conventional strawberries, blueberries, apples, grapes, nectarines, peaches and pears grown in the US, the DRI was 3 for organics, versus 24 for conventional fruits. Imported conventional fruits from Chile and Argentina have much higher DRIs than those grown in the US, because of more stringent regulations of pesticide use in the US.
According to Professor Benbrook, there is compelling evidence that low level exposure to organophosphate insecticides in food are contributing to neurologic and developmental problems in children, such as lowered IQ. Lead exposure was found to be most harmful in a Harvard study, followed by organophosphate pesticides and methylmercury. The most compelling evidence of harm comes from the insecticide chlorpyrifos, which has been banned by the EPA for home use, but is still permitted in agriculture. Its level in pregnant farmworkers correlated with lower IQs in their children. When researchers at Emory University in Atlanta gave children organic fruits and vegetables, chlorpyrifos levels fell to almost undetectable levels in their urine in 5 days. Chlorpyrifos is made by Dow Chemical. A coalition of farmworker and advocacy groups filed a lawsuit against the EPA in 2007 seeking to ban the use of chlorpyrifos; the suit is still pending.
Professor Benbrook thinks that the most important dietary change we can make is to eat more fruits and vegetables, and less bad fat, added sugar and processed food. I’m going to add – eat with the seasons, so that you avoid imported produce with its higher levels of pesticides. The second most important is – of course - to eat organic produce and organic grains. If you can afford it, this is your most important step.
Subscribe to the Nutrition Action Healthletter if you want to keep up with the science of nutrition in an easy, readable format. It’s easy to find the address on-line, and 10 issues cost only $10!
Finally – let always give thanks to our local organic farmers, and to the Bolinas People’s store with its daily array of luscious, healthy food!
Sadja Greenwood MD back issues at on this blog
Sunday, September 16, 2012
Olive Oil - What are its advantages?
New studies show some surprising benefits for olive oil, including a possible protective effect on bone. Spanish research, to be published in the October issue of the Journal of Clinical Endocrinology and Metabolism, shows that consumption of a Mediterranean diet enriched with olive oil is associated with increased serum osteocalcin and other bone formation markers. Osteocalcin is produced by bone cells called osteoblasts, and is used as a marker for bone formation. Prior to this study, it had been noted that the incidence of osteoporosis in Europe was lower in the Mediterranean basin. All subjects in this study were instructed to eat a Mediterranean diet, rich in fruits and vegetables, lean protein from fish, poultry, and beans, and whole grains instead of white flour bread and pasta. Olive oil was their added fat.
Another Spanish study in 2010 showed that the phenolic compounds in extra virgin olive oil change how genes function. Phenols are chemical compounds found in plants that have many unique properties. In conjunction with a Mediterranean diet, genes related to atherosclerosis were down regulated, and there was a positive impact on oxidation of fats and DNA, insulin resistance, inflammation, carcinogenesis and tumor suppression. Atherosclerosis is a disorder that occurs when fat, cholesterol and other substances build up in the walls of arteries and form hard structures called plaques. This diminishes blood flow and can lead to heart attack and stroke.
Breast cancer risk may also be modified by virgin olive oil. Spanish scientists at the University of Barcelona decoded the signals within breast tumor cells activated by olive oil, concluding that benefits include decrease in activity of an oncogene, and stimulation of tumor cell death. An oncogene is a gene that has the potential to cause cancer, if activated by mutations in another gene or certain environmental factors. Olive oil also showed ability to prevent DNA damage. Corn oil and some other vegetable oils high in polyunsaturated fatty acids, can increase the aggressiveness of cancers.
Virgin olive oil is oil produced by crushing olives mechanically, with no chemical treatment. It has an acidity of less than 1.5%. Extra virgin olive oil comes from virgin olive oil and is lower in acidity (less than 0.8%) and is judged to have the best taste. Virgin olive oils contain the highest levels of phenolic compounds and anti-oxidants that have been linked with better health.
Using olive oil or canola oil on your salads will give you the best absorption of carotenes from colorful vegetables, according to a new study from Purdue University. Low fat and non-fat salad dressings resulted in minimal carotene absorption. Carotenes are pigments that occur in vegetables and fruits and have multiple healthy properties. Avocado is another healthy fat that enhances carotene absorption. If you do use canola oil, make sure that it is organic. Otherwise you will be using genetically modified canola that may be high in pesticides and herbicides, as ‘superweeds’ and resistant insects have evolved to make the application of Roundup less effective. More spraying is necessary.
Your vote in support of Proposition 37 in November will help to ensure that genetically modified food products are labeled in California. This is a huge issue for food companies, who have raised millions against the proposition. Stay tuned, and read the arguments on your ballot carefully.
Sadja Greenwood, MD, MPH back issues on this blog
Another Spanish study in 2010 showed that the phenolic compounds in extra virgin olive oil change how genes function. Phenols are chemical compounds found in plants that have many unique properties. In conjunction with a Mediterranean diet, genes related to atherosclerosis were down regulated, and there was a positive impact on oxidation of fats and DNA, insulin resistance, inflammation, carcinogenesis and tumor suppression. Atherosclerosis is a disorder that occurs when fat, cholesterol and other substances build up in the walls of arteries and form hard structures called plaques. This diminishes blood flow and can lead to heart attack and stroke.
Breast cancer risk may also be modified by virgin olive oil. Spanish scientists at the University of Barcelona decoded the signals within breast tumor cells activated by olive oil, concluding that benefits include decrease in activity of an oncogene, and stimulation of tumor cell death. An oncogene is a gene that has the potential to cause cancer, if activated by mutations in another gene or certain environmental factors. Olive oil also showed ability to prevent DNA damage. Corn oil and some other vegetable oils high in polyunsaturated fatty acids, can increase the aggressiveness of cancers.
Virgin olive oil is oil produced by crushing olives mechanically, with no chemical treatment. It has an acidity of less than 1.5%. Extra virgin olive oil comes from virgin olive oil and is lower in acidity (less than 0.8%) and is judged to have the best taste. Virgin olive oils contain the highest levels of phenolic compounds and anti-oxidants that have been linked with better health.
Using olive oil or canola oil on your salads will give you the best absorption of carotenes from colorful vegetables, according to a new study from Purdue University. Low fat and non-fat salad dressings resulted in minimal carotene absorption. Carotenes are pigments that occur in vegetables and fruits and have multiple healthy properties. Avocado is another healthy fat that enhances carotene absorption. If you do use canola oil, make sure that it is organic. Otherwise you will be using genetically modified canola that may be high in pesticides and herbicides, as ‘superweeds’ and resistant insects have evolved to make the application of Roundup less effective. More spraying is necessary.
Your vote in support of Proposition 37 in November will help to ensure that genetically modified food products are labeled in California. This is a huge issue for food companies, who have raised millions against the proposition. Stay tuned, and read the arguments on your ballot carefully.
Sadja Greenwood, MD, MPH back issues on this blog
Sunday, September 9, 2012
Dr. Oz on Longevity
Who is Dr. Oz? Mehmet Oz is a cardiac surgeon from Columbia University who has become a popular author and energetic television promoter for getting fit, losing weight and staying healthy. His books, co-authored with Michael Roizen, include You: The Owner’s Manual, and You: On a Diet; they explain the workings of the body and its organs clearly and simply. Dr. Oz’s television program (weekdays at 4, channel 2)) shows a charismatic doc in surgical scrubs promoting a great variety of techniques for staying fit and losing weight, along with numerous products to help you on your way. He is fun to watch. Here are his 10 simple habits that could help you live to 100, with my comments tacked on.
1. Add red foods to your diet. Oz suggests red cabbage, as cruciferous vegetables help to protect against cancer, and beet juice, with nitrates that relax blood vessels. I will add that beets are a great food because the nitrates in beets, also found in green leafy vegetables, are a source of nitric oxide in the body, which dilates blood vessels, improves blood flow, and lowers blood pressure. Other red foods are tomatoes and watermelon, high in the beneficial antioxidant lycopene, and red wine and red grapes, with resveratrol. Resveratrol is currently under study as a substance with anti-inflammatory properties and cardiovascular benefits. It is also found in peanuts and chocolate. I think it is wiser to get resveratrol in foods than in supplements.
2. Black tea – have a cup daily to boost your survival after a heart attack. I will add that research from The Netherlands showed that drinking 3-6 cups of tea daily was associated with a 45% reduced risk of death from heart disease.
3.Dial one phone number from memory every day. Oz advises using your memory rather than relying on your devices. I will add that there are many ways to exercise your memory, including memorizing new words, school work, a new language, poems, music and songs. Work on this while you walk or work out, and just before sleep at night.
4. Use the first stall in a public restroom to prevent getting sick. Oz says the first stall is used less often, as people want more privacy, and it contains the lowest bacteria counts. I’ll add that washing your hands is also very important. Taking a daily probiotic is vital to amp up your immune system (the majority of your immune tissue lines your gut). Vitamin D also helps to prevent respiratory illness.
5. Take two steps at a time when you climb stairs. If you can’t do that, try walking up the stairs twice. I’ll add that keeping your legs strong is important for balance as well as for walking and other sports. If you don’t have stairs at home, you can get step-up blocks or risers at a sporting goods store or on the internet. Resistance training at home or in a gym is really important.
6. Stretch after a hot shower to prevent pain – stretching is best when muscles are warm; stretching improves posture and prevents muscle soreness. Oz suggests raising your arms, bending forward to the right slowly, and then to the left. I would add that that any other standing stretching exercise you like can also be helpful.
7. Hold your breath: take a deep breath, hold for 10 seconds, and then slowly exhale through pursed lips. I think this is a wonderful daily practice, not only for singers and wind instrument players but for all of us who breathe. Yoga classes emphasize many kinds of breathing, to stimulate and relax the body.
8. Do the Reverse Warrior Pose: For this exercise, I suggest you watch Yoga Reverse Warrior Pose by Jennifer Kostel on YouTube. Her presentation is simple and not extreme. Do it on both sides. It promotes balance, flexibility and strength.
9.Chew your food 20 times – slowing down your eating will increase your enjoyment of food, and help to prevent diabetes. If this is hard, put down your fork between bites. I have found the chewing practice to be extremely helpful in preventing reflux pain at midnight. By extra chewing, you start the digestive process (with digestive enzymes in saliva) and make less grinding work for your stomach. It can empty faster. I’m a convert.
10. Cut your cravings in half to cut calories. When confronted with ‘must have’ chips or cookies, Dr. Oz wants you to ‘halve them’. Put the second half away and out of sight. My thinking is that this works well for some people, but others with food addictions need to have the tempting foods out of the house. Don’t shop when you are hungry, and don’t buy foods you will binge on.
Dr. Oz is a television wonder, on a nationwide mission to get us slimmer and more fit. I know it’s daytime TV, but watch him if you have a chance.
Sadja Greenwood, MD, MPH back issues at on this blog
Sunday, August 26, 2012
Lists for Longevity
Back to school, Labor day: is it time to make lists and get organized? Here are ten suggestions from the August issue of Tufts University Health and Nutrition Letter. Next week I’ll report on Dr Oz’s 10 simple habits that could help you live to 100.
1. Combining moderate regular exercise and mentally stimulating activities can help protect your memory as you age, according to a Mayo Clinic study.
2. Raisins, a handful eaten 3 times a day, can reduce blood pressure significantly in mildly hypertensive people according to study from the Louisville Metabolic and Atherosclerosis Research Center. This may be because raisins are high in potassium, and also in fiber and healthful anti-oxidants. There are opposing views on whether raisins promote or prevent tooth decay, so keep flossing.
3. Your waist to hip ratio can predict you risk of sudden cardiac death. Best measurements are under 0.82 for women and 0.92 for men. Use a tape measure.
4. Regular jogging, at a slow to average pace, increases longevity, according to the Copenhagen City Heart Study. (Be sure to check with your doctor before starting to jog, if you don’t do so currently).
5. Fiber may help to protect against heart disease and stroke, according to a Swedish study.
6.Switching from white rice to brown rice could reduce your risk of diabetes, according to a Harvard study. This is especially important for Asians if they eat a lot of white rice.
7. Skip sugar sweetened beverages to reduce your risk of heart attack, according to the Nurses’ Health Study and the Health Professionals study. No increased risk was found for diet sodas.
8. Eating a Mediterranean diet, already linked to a lower risk of chronic diseases, leads to a better health-related quality of life, according to Spanish research. This diet is high in vegetables, fruit, fish or poultry, whole grains, nuts and olive oil, with small amounts of low fat milk as yogurt. There is new evidence that olive oil may strengthen bones. The diet avoids red meat and dairy fat. Get a book on this way of eating – The New Mediterranean Diet Cookbook by Nancy Harmon Jenkins and Marion Nestle is a winner.
9. Low-fat dairy may lead to fewer strokes, according to a Swedish Study.
10. Any physical activity: formal exercise, gardening, housework and walking may lower the risk of Alzheimers’s disease, according to a study of older adults at Rush University.
These studies in the Tufts newsletter are a good reminder of what you already know about healthy living.
Here are my additional suggestions for people who watch television, home movies and sit at a desk for work. Invest in a minicycle or pedal exerciser. These small devices use no electricity and can fit under your desk or in a corner for storage. They keep your legs moving with mild but continuous exercise while you sit. On a table, they are also used to exercise the arms and shoulders. The Sunny health and fitness minicycle is about $57 and is available from Amazon and Overstock. You can also look at the Carex Pedal exerciser (lighter and about $45) and the Pedlar Pro #316 (about $34). Alternatively, consider a standing desk. Prolonged sitting (at work, in the car, watching TV) is not good for the metabolism. Several recent studies show that prolonged sitting increases mortality. You may be able to raise your desk on a sturdy brick pile until the desk-top is at elbow height, but if it is not stable, make or buy a standing desk. It takes a few tries to get used to a standing desk, but it is worth the effort in terms of leg strength and endurance. Finally, you can invest in a trek desk, which enables you to walk slowly on a treadmill while working on the computer, reading or thinking. There are manual treadmills that do not require electricity.
There’s a famous t-shirt that says “If it’s physical, it’s therapy.”
Sadja Greenwood MD, MPH back issues on this blog
Leave me a message, or a question, if you like. I'll answer, for sure.
1. Combining moderate regular exercise and mentally stimulating activities can help protect your memory as you age, according to a Mayo Clinic study.
2. Raisins, a handful eaten 3 times a day, can reduce blood pressure significantly in mildly hypertensive people according to study from the Louisville Metabolic and Atherosclerosis Research Center. This may be because raisins are high in potassium, and also in fiber and healthful anti-oxidants. There are opposing views on whether raisins promote or prevent tooth decay, so keep flossing.
3. Your waist to hip ratio can predict you risk of sudden cardiac death. Best measurements are under 0.82 for women and 0.92 for men. Use a tape measure.
4. Regular jogging, at a slow to average pace, increases longevity, according to the Copenhagen City Heart Study. (Be sure to check with your doctor before starting to jog, if you don’t do so currently).
5. Fiber may help to protect against heart disease and stroke, according to a Swedish study.
6.Switching from white rice to brown rice could reduce your risk of diabetes, according to a Harvard study. This is especially important for Asians if they eat a lot of white rice.
7. Skip sugar sweetened beverages to reduce your risk of heart attack, according to the Nurses’ Health Study and the Health Professionals study. No increased risk was found for diet sodas.
8. Eating a Mediterranean diet, already linked to a lower risk of chronic diseases, leads to a better health-related quality of life, according to Spanish research. This diet is high in vegetables, fruit, fish or poultry, whole grains, nuts and olive oil, with small amounts of low fat milk as yogurt. There is new evidence that olive oil may strengthen bones. The diet avoids red meat and dairy fat. Get a book on this way of eating – The New Mediterranean Diet Cookbook by Nancy Harmon Jenkins and Marion Nestle is a winner.
9. Low-fat dairy may lead to fewer strokes, according to a Swedish Study.
10. Any physical activity: formal exercise, gardening, housework and walking may lower the risk of Alzheimers’s disease, according to a study of older adults at Rush University.
These studies in the Tufts newsletter are a good reminder of what you already know about healthy living.
Here are my additional suggestions for people who watch television, home movies and sit at a desk for work. Invest in a minicycle or pedal exerciser. These small devices use no electricity and can fit under your desk or in a corner for storage. They keep your legs moving with mild but continuous exercise while you sit. On a table, they are also used to exercise the arms and shoulders. The Sunny health and fitness minicycle is about $57 and is available from Amazon and Overstock. You can also look at the Carex Pedal exerciser (lighter and about $45) and the Pedlar Pro #316 (about $34). Alternatively, consider a standing desk. Prolonged sitting (at work, in the car, watching TV) is not good for the metabolism. Several recent studies show that prolonged sitting increases mortality. You may be able to raise your desk on a sturdy brick pile until the desk-top is at elbow height, but if it is not stable, make or buy a standing desk. It takes a few tries to get used to a standing desk, but it is worth the effort in terms of leg strength and endurance. Finally, you can invest in a trek desk, which enables you to walk slowly on a treadmill while working on the computer, reading or thinking. There are manual treadmills that do not require electricity.
There’s a famous t-shirt that says “If it’s physical, it’s therapy.”
Sadja Greenwood MD, MPH back issues on this blog
Leave me a message, or a question, if you like. I'll answer, for sure.
Sunday, August 12, 2012
More Good News About Exercise and Coffee
We all know that it’s good to get moving, but why? Will walking and other forms of exercise do more than help us stay trim? Here’s a study from Japan, in the British Medical Journal, that shows an association between time spent walking, life expectancy and lifetime expenditure for medical care. Researchers from Japanese medical schools followed 28,000 men and women aged 40-79, and divided them into those who walked an hour or more a day, and those who walked less than an hour. The more active group had a significantly longer life expectancy and lower lifetime medical expenditure. They concluded that increased longevity resulting from a healthier lifestyle does not necessarily translate into an increased amount of medical costs throughout life.
Health care costs are important in Japan, as here, because the country has a universal health care insurance system. People without insurance can join a national insurance program administered by local governments. People can select doctors or facilities of their choice, and cannot be denied coverage. Sounds familiar? This system is similar to the Affordable Care Act being implemented in the US.
A similar study from The University of Texas was recently published the journal Circulation. The authors studied 63,000 men and women over 0-10 years, 10 to 20 years, and beyond 20 years. Their fitness was based on age and sex -adjusted treadmill times, as found at the Cooper Center. High fitness was associated with lesser mortality from all causes and from cardiovascular causes.
A recent article in the Journal of the National Cancer Institute reviewed the effects of physical activity on people with cancer. Edward Giovannucci of the Harvard School of Public Health, made the following comments in his review of the article. Survival after cancer, although it may be dependent on the destructive behavior of the tumor, is also related to the general health of the patient. Health is often enhanced by activity. In addition, physical activity can have a direct effect on the cancer by altering various hormones, including insulin, insulinlike growth factor 1, estrogen and adiponectin (a protein involved in regulating blood sugar and fatty acid breakdown). These factors can promote or inhibit cell growth; insulin is a possible growth promoter for cancer, and exercise results in lower insulin levels. Observational studies of breast cancer (17 studies) and colon cancer (6 studies) suggest that physically active people have better cancer-specific and all-cause survival. Despite problems in comparing types of breast and colon cancer, and the presence or absence of metastases, the studies look promising. Few other leads have shown as much promise in extending the lives of cancer survivors, and activity can also improve the quality life of survivors. Giovannucci concludes that physical activity should be a standard part of cancer care.
More good news about coffee: In a new study from the National Institutes of Health, coffee drinkers who did not smoke were less likely to die in the next 14 years from a wide variety of illnesses. Total mortality was less in coffee drinkers, but deaths from cancer did not show this trend. Men showed an increasing benefit from coffee for up to 5 cups a day, and women who drank 2 cups a day showed a mortality benefit. Decaf coffee was also helpful.
If coffee helps you get out for a walk, a jog, a game of tennis or a swim, go for all of it! Now that it’s foggy and cool in West Marin, it’s great time to get started and keep it up.
Sadja Greenwood, MD back issues at
sadjascolumns.blogspot.com
Health care costs are important in Japan, as here, because the country has a universal health care insurance system. People without insurance can join a national insurance program administered by local governments. People can select doctors or facilities of their choice, and cannot be denied coverage. Sounds familiar? This system is similar to the Affordable Care Act being implemented in the US.
A similar study from The University of Texas was recently published the journal Circulation. The authors studied 63,000 men and women over 0-10 years, 10 to 20 years, and beyond 20 years. Their fitness was based on age and sex -adjusted treadmill times, as found at the Cooper Center. High fitness was associated with lesser mortality from all causes and from cardiovascular causes.
A recent article in the Journal of the National Cancer Institute reviewed the effects of physical activity on people with cancer. Edward Giovannucci of the Harvard School of Public Health, made the following comments in his review of the article. Survival after cancer, although it may be dependent on the destructive behavior of the tumor, is also related to the general health of the patient. Health is often enhanced by activity. In addition, physical activity can have a direct effect on the cancer by altering various hormones, including insulin, insulinlike growth factor 1, estrogen and adiponectin (a protein involved in regulating blood sugar and fatty acid breakdown). These factors can promote or inhibit cell growth; insulin is a possible growth promoter for cancer, and exercise results in lower insulin levels. Observational studies of breast cancer (17 studies) and colon cancer (6 studies) suggest that physically active people have better cancer-specific and all-cause survival. Despite problems in comparing types of breast and colon cancer, and the presence or absence of metastases, the studies look promising. Few other leads have shown as much promise in extending the lives of cancer survivors, and activity can also improve the quality life of survivors. Giovannucci concludes that physical activity should be a standard part of cancer care.
More good news about coffee: In a new study from the National Institutes of Health, coffee drinkers who did not smoke were less likely to die in the next 14 years from a wide variety of illnesses. Total mortality was less in coffee drinkers, but deaths from cancer did not show this trend. Men showed an increasing benefit from coffee for up to 5 cups a day, and women who drank 2 cups a day showed a mortality benefit. Decaf coffee was also helpful.
If coffee helps you get out for a walk, a jog, a game of tennis or a swim, go for all of it! Now that it’s foggy and cool in West Marin, it’s great time to get started and keep it up.
Sadja Greenwood, MD back issues at
sadjascolumns.blogspot.com
Monday, July 30, 2012
Eve Ensler and The Vagina Monologues
She is one of the most energetic revolutionaries in the world today, with her ambition to end violence against women and girls, everywhere. Eve Ensler has launched a global movement known as V-Day, to end rape, battery, incest, female genital mutilation and sex slavery. She has set up a community in the Democratic Republic of the Congo, called the City of Joy, to help Congolese women who have been raped. Classes in literacy, self-defense, communication, political action and mental and physical healing were held in the first year. A terrible history of widespread and violent rape had made such a center important in the Congo.
Through V-Day campaigns, volunteers and college students in this country put on benefit performances of Ensler’s plays, including The Vagina Monologues. They hold teach-ins and workshops for men, to raise awareness and funds for grassroots anti-violence groups. V-Day has produced a documentary film, Until the Violence Stops; this72 minute documentary is available from Netflicks. It shows women from Harlem, Ukiah, Pine Ridge Reservation to the Philippines and Kenya, revealing their experiences of abuse and genital mutilation, and what they are doing to improve their situations. A five minute trailer for this film can be seen on You Tube.
Funds raised by V-Day support local and national organizations worldwide, including Egypt, Iraq and Afghanistan. The V-Day movement exists in 140 countries from Europe to Asia, Africa, the Americas, and the Caribbean.
In June, 2012, Michigan State Representative Lisa Brown was banned from speaking during a debate on a bill putting new restrictions on abortion providers, because she had used the word ‘vagina’ in her remarks. As a result, four days later a special and rousing performance of The Vagina Monologues was staged on the steps of the state capital, before a crowd of 5000. Eve Ensler was on hand. You can watch the action on You Tube – Vagina Monologues at Michigan’s Capitol Steps.
The Vagina Monologues was written in 1996 and first performed in Greenwich Village, New York City. It has been translated into 48 languages and performed in over 140 countries. Clearly it has been a powerful opening for women to talk about their sexual selves, their joy, their anger and their liberation from prudery and restrictive customs. Ensler has written numerous other plays, including “I am an Emotional Creature: The Secret Life of Girls Around the World.” This play was recently staged at the Berkeley Repertory Theater. It features a cast of 6 young women who talk, sing, and dance their way through a script that covers cliques, popularity, sex, sexual slavery, genital mutilation, slave labor in a Barbie Doll factory and more. The brilliant cast has now gone to New York City.
Here’s the big news of this column. The Vagina Monologues is coming to Marin, and specifically to Bolinas! It will play at the Bolinas Community Center on Saturday, September 22nd at 7:30 pm. It will be staged at the San Geronimo Cultural Center on September 15th, and at Toby’s in Point Reyes on Friday September 21st. This play (which I have seen several times) is different at each staging as the cast and venue changes. It is much more than a ladies’ night out; men and couples will also get a lot out of it, including humor, sadness, surprise, and a powerful understanding of the human condition.
Sadja Greenwood, MD, MPH: back issues on this blog. Leave me a note, and I'll answer you pronto. Pura Vida
Through V-Day campaigns, volunteers and college students in this country put on benefit performances of Ensler’s plays, including The Vagina Monologues. They hold teach-ins and workshops for men, to raise awareness and funds for grassroots anti-violence groups. V-Day has produced a documentary film, Until the Violence Stops; this72 minute documentary is available from Netflicks. It shows women from Harlem, Ukiah, Pine Ridge Reservation to the Philippines and Kenya, revealing their experiences of abuse and genital mutilation, and what they are doing to improve their situations. A five minute trailer for this film can be seen on You Tube.
Funds raised by V-Day support local and national organizations worldwide, including Egypt, Iraq and Afghanistan. The V-Day movement exists in 140 countries from Europe to Asia, Africa, the Americas, and the Caribbean.
In June, 2012, Michigan State Representative Lisa Brown was banned from speaking during a debate on a bill putting new restrictions on abortion providers, because she had used the word ‘vagina’ in her remarks. As a result, four days later a special and rousing performance of The Vagina Monologues was staged on the steps of the state capital, before a crowd of 5000. Eve Ensler was on hand. You can watch the action on You Tube – Vagina Monologues at Michigan’s Capitol Steps.
The Vagina Monologues was written in 1996 and first performed in Greenwich Village, New York City. It has been translated into 48 languages and performed in over 140 countries. Clearly it has been a powerful opening for women to talk about their sexual selves, their joy, their anger and their liberation from prudery and restrictive customs. Ensler has written numerous other plays, including “I am an Emotional Creature: The Secret Life of Girls Around the World.” This play was recently staged at the Berkeley Repertory Theater. It features a cast of 6 young women who talk, sing, and dance their way through a script that covers cliques, popularity, sex, sexual slavery, genital mutilation, slave labor in a Barbie Doll factory and more. The brilliant cast has now gone to New York City.
Here’s the big news of this column. The Vagina Monologues is coming to Marin, and specifically to Bolinas! It will play at the Bolinas Community Center on Saturday, September 22nd at 7:30 pm. It will be staged at the San Geronimo Cultural Center on September 15th, and at Toby’s in Point Reyes on Friday September 21st. This play (which I have seen several times) is different at each staging as the cast and venue changes. It is much more than a ladies’ night out; men and couples will also get a lot out of it, including humor, sadness, surprise, and a powerful understanding of the human condition.
Sadja Greenwood, MD, MPH: back issues on this blog. Leave me a note, and I'll answer you pronto. Pura Vida
Saturday, July 7, 2012
The Affordable Care Act - what it means to you
In a dramatic and unexpected move , Supreme Court Chief Justice John Roberts sided with liberal justices Stephen Breyer, Ruth Bader Ginsberg, Elena Kagan and Sonia Sotomayor to allow most of President Obama’s health care law, the Affordable Care Act, to remain intact. Here are the essential features that may be of interest.
The “mandate” that everyone will need to buy insurance by 2014 was the most controversial part of the new law. The justices decided that it will remain under the taxing power of the government. Anyone who refuses to buy insurance will be taxed $95 in the first year, and subsequently more, until the tax reaches $695 or 2.5 percent of income, whichever is more. However, there will be federal subsidies for people who cannot afford insurance. Many uninsured people with pre-existing conditions will be eligible for insurance and will probably sign up quickly. If a substantial fraction of healthy young people also sign up, insurance companies will be able to even out costs and charge less.
Those politically opposed to the act will advise the public not to purchase insurance, which could result in higher premiums for those who do. This dynamic has already started, and it will greatly influence how the new law will work. Here’s a way for healthy young people to think about insurance: Their likelihood of having a heart attack and other chronic disease is low, so they can probably save money by just paying the tax. However, should they have a serious accident or develop an unexpected illness, they might receive expensive emergency hospital care, be ineligible for some important forms of treatment, and be burdened by large debts while recovering. Getting health insurance will avoid these problems. It is a smart and prudent option.
New money is being offered to states to help enroll people with limited finances into Medicaid programs. If a state turns down the new funding from the act, it can still keep its current federal Medicaid funds. Republican governors may want to turn down the new funds; however, hospitals and care providers are going to pressure them to accept the greatly expanded funding in order to have more of their patients insured.
California will benefit from the new funding for Medicaid — currently we have 7 million uninsured people, a number expected to fall by more than half by 2016 due to the new funds. There will be a substantial increase in the number of people insured by Medi-Cal, and county and University of California hospitals are working to improve their delivery of care. California plans to enroll more low-income seniors and people with disabilities into managed care. These plans must have a sufficient number of providers and be geographically near the patients. As this occurs, California and other states will face challenges in finding enough primary care providers to care for more insured people.
Coverage of children under 26 in their parents’ insurance policies is already in force and is very popular. Starting in 2014, people with pre-existing conditions will be able to buy insurance. Insurance companies will not be able to charge the sick more than the healthy, nor can they charge women more than men. Free wellness checkups will be part of all plans. Insurance companies will have to spend at least 80 percent of their revenue on medical care, which may limit their administrative costs and high executive salaries.
By January 1, 2014, states will be required to have new marketplaces, called exchanges, in which individuals and small businesses can examine a variety of competing plans, their costs and their policies, before purchasing them. States must begin talking to a federal hub that is being created to help determine who is eligible for subsidies. Within 10 days after the November election, states are supposed to report to the federal government on their readiness to set up the exchanges, and must get them ready in 2013. If a state does not comply, residents can access a federal “fallback” exchange. To get a subsidy, you must buy your insurance through an exchange.
Readers may be happy to know that California is a leader in working toward having an exchange ready by late 2013.
The Affordable Care Act is a start on the path towards healthcare for everyone. It is not as efficient as an expansion of Medicare for all, which would be like a single payer plan. It is extremely controversial, so we can expect a lot of political fallout in coming months. Republicans vow to overturn the ACA if they return to power. However, it is a great accomplishment of the Obama administration in the current political climate. Here’s one more compelling reason to vote in November.
Sadja Greenwood, MD, MPH
Read back issues on this blog. Leave me a message, and I'll answer you!
The “mandate” that everyone will need to buy insurance by 2014 was the most controversial part of the new law. The justices decided that it will remain under the taxing power of the government. Anyone who refuses to buy insurance will be taxed $95 in the first year, and subsequently more, until the tax reaches $695 or 2.5 percent of income, whichever is more. However, there will be federal subsidies for people who cannot afford insurance. Many uninsured people with pre-existing conditions will be eligible for insurance and will probably sign up quickly. If a substantial fraction of healthy young people also sign up, insurance companies will be able to even out costs and charge less.
Those politically opposed to the act will advise the public not to purchase insurance, which could result in higher premiums for those who do. This dynamic has already started, and it will greatly influence how the new law will work. Here’s a way for healthy young people to think about insurance: Their likelihood of having a heart attack and other chronic disease is low, so they can probably save money by just paying the tax. However, should they have a serious accident or develop an unexpected illness, they might receive expensive emergency hospital care, be ineligible for some important forms of treatment, and be burdened by large debts while recovering. Getting health insurance will avoid these problems. It is a smart and prudent option.
New money is being offered to states to help enroll people with limited finances into Medicaid programs. If a state turns down the new funding from the act, it can still keep its current federal Medicaid funds. Republican governors may want to turn down the new funds; however, hospitals and care providers are going to pressure them to accept the greatly expanded funding in order to have more of their patients insured.
California will benefit from the new funding for Medicaid — currently we have 7 million uninsured people, a number expected to fall by more than half by 2016 due to the new funds. There will be a substantial increase in the number of people insured by Medi-Cal, and county and University of California hospitals are working to improve their delivery of care. California plans to enroll more low-income seniors and people with disabilities into managed care. These plans must have a sufficient number of providers and be geographically near the patients. As this occurs, California and other states will face challenges in finding enough primary care providers to care for more insured people.
Coverage of children under 26 in their parents’ insurance policies is already in force and is very popular. Starting in 2014, people with pre-existing conditions will be able to buy insurance. Insurance companies will not be able to charge the sick more than the healthy, nor can they charge women more than men. Free wellness checkups will be part of all plans. Insurance companies will have to spend at least 80 percent of their revenue on medical care, which may limit their administrative costs and high executive salaries.
By January 1, 2014, states will be required to have new marketplaces, called exchanges, in which individuals and small businesses can examine a variety of competing plans, their costs and their policies, before purchasing them. States must begin talking to a federal hub that is being created to help determine who is eligible for subsidies. Within 10 days after the November election, states are supposed to report to the federal government on their readiness to set up the exchanges, and must get them ready in 2013. If a state does not comply, residents can access a federal “fallback” exchange. To get a subsidy, you must buy your insurance through an exchange.
Readers may be happy to know that California is a leader in working toward having an exchange ready by late 2013.
The Affordable Care Act is a start on the path towards healthcare for everyone. It is not as efficient as an expansion of Medicare for all, which would be like a single payer plan. It is extremely controversial, so we can expect a lot of political fallout in coming months. Republicans vow to overturn the ACA if they return to power. However, it is a great accomplishment of the Obama administration in the current political climate. Here’s one more compelling reason to vote in November.
Sadja Greenwood, MD, MPH
Read back issues on this blog. Leave me a message, and I'll answer you!
Thursday, June 28, 2012
Beneficial Bacteria in your Body
Microbiologists are excited about recent studies showing that the bacteria in our guts, throat, genital organs and on our skin can have newly discovered beneficial roles in health. We have some 500 different strains of bacteria in our intestinal tract; the average healthy adult carries about 5 pounds of them. From the mouth to the colon, they help us break down and digest our food and allow for its absorption. They also synthesize a range of vitamins, from the B group to vitamin K.
About 70% of our immune system resides in the lining of the gut; signals from good bacteria influence immune cell development and susceptibility to infections and inflammatory diseases. Researchers at the University of Pennsylvania have shown that when mice are treated with antibiotics to reduce numbers of beneficial bacteria, they have an impaired antiviral immune response and delayed clearance of systemic viruses or influenza in the airways. The researchers concluded that signals from beneficial bacteria stimulate immune cells in a way that is optimal for antiviral immunity.. This may be a way that good gut bacteria reduce your susceptibility to colds and flu.
The same researchers also looked at allergic lung inflammation, similar to asthma in humans, and found that mice given antibiotics had higher levels of basophils in their white blood cells, and elevated seum IgE – seen in allergic disease. Researchers at the University of British Columbia found that mice treated with the antibiotic vancomycin reduced the diversity of microbes in the gut and increased the susceptibility of the animals to experimentally induced asthma. They conclude that normal bacterial populations can positively influence the response to allergens in the environment, making inflammation and asthma less likely. The bacterial multitudes in our bodies may have functions never before appreciated.
Antibiotics are life-saving drugs in many situations, including streptococcal throat infections (that can lead to heart valve damage), bacterial meningitis, bacterial pneumonia, urinary tract infections, et al. The purport of this column is not to criticize their use when needed, but to underline the importance of beneficial bacteria in the gut.
Research on the ‘microbiome’ is a hot topic currently, with exciting implications for human health. Microbiome is defined as the totality of microbes in the body (bacteria, viruses and fungi), their genetic elements and environmental interactions. What you can do right now to keep your microbiome in good shape is to feed your helpful intestinal bacteria the right food. Sugary foods that are low in fiber allow the ‘bad’ microbes to thrive. Avoid them. Certain foods are known as ‘prebiotics’ can help our beneficial bacteria. Examples are whole grains, oats, bananas, garlic & onions, artichokes and asparagus. In addition, many people take a ‘probiotic’ supplement that contains beneficial bacteria, and also eat fermented foods such as yogurt, kefir, and sauerkraut. Make sure the yogurt you buy contains living cultures, and avoid ones that are sweetened – it’s better to add fruit yourself. You can buy probiotic capsules at many grocery stores. Look in the refrigerated section and keep the capsules refrigerated at home to preserve the life of the bacteria therein.
If you take antibiotics for a bacterial infection, it’s a good idea to take a probiotic to restore your beneficial bacteria. This may help to prevent serious diarrhea after antibiotic use, which can occur when bad bacteria such as Clostridium difficile take over. Wait at least 2 hours after taking the antibiotic, so it can be absorbed into your bloodstream, before taking the probiotic. If you have asthma, a probiotic supplement might help – talk to you doctor about this.
Sadja Greenwood, MD, MPH - back issues on this blog. Write me a comment, and I'll answer you.
About 70% of our immune system resides in the lining of the gut; signals from good bacteria influence immune cell development and susceptibility to infections and inflammatory diseases. Researchers at the University of Pennsylvania have shown that when mice are treated with antibiotics to reduce numbers of beneficial bacteria, they have an impaired antiviral immune response and delayed clearance of systemic viruses or influenza in the airways. The researchers concluded that signals from beneficial bacteria stimulate immune cells in a way that is optimal for antiviral immunity.. This may be a way that good gut bacteria reduce your susceptibility to colds and flu.
The same researchers also looked at allergic lung inflammation, similar to asthma in humans, and found that mice given antibiotics had higher levels of basophils in their white blood cells, and elevated seum IgE – seen in allergic disease. Researchers at the University of British Columbia found that mice treated with the antibiotic vancomycin reduced the diversity of microbes in the gut and increased the susceptibility of the animals to experimentally induced asthma. They conclude that normal bacterial populations can positively influence the response to allergens in the environment, making inflammation and asthma less likely. The bacterial multitudes in our bodies may have functions never before appreciated.
Antibiotics are life-saving drugs in many situations, including streptococcal throat infections (that can lead to heart valve damage), bacterial meningitis, bacterial pneumonia, urinary tract infections, et al. The purport of this column is not to criticize their use when needed, but to underline the importance of beneficial bacteria in the gut.
Research on the ‘microbiome’ is a hot topic currently, with exciting implications for human health. Microbiome is defined as the totality of microbes in the body (bacteria, viruses and fungi), their genetic elements and environmental interactions. What you can do right now to keep your microbiome in good shape is to feed your helpful intestinal bacteria the right food. Sugary foods that are low in fiber allow the ‘bad’ microbes to thrive. Avoid them. Certain foods are known as ‘prebiotics’ can help our beneficial bacteria. Examples are whole grains, oats, bananas, garlic & onions, artichokes and asparagus. In addition, many people take a ‘probiotic’ supplement that contains beneficial bacteria, and also eat fermented foods such as yogurt, kefir, and sauerkraut. Make sure the yogurt you buy contains living cultures, and avoid ones that are sweetened – it’s better to add fruit yourself. You can buy probiotic capsules at many grocery stores. Look in the refrigerated section and keep the capsules refrigerated at home to preserve the life of the bacteria therein.
If you take antibiotics for a bacterial infection, it’s a good idea to take a probiotic to restore your beneficial bacteria. This may help to prevent serious diarrhea after antibiotic use, which can occur when bad bacteria such as Clostridium difficile take over. Wait at least 2 hours after taking the antibiotic, so it can be absorbed into your bloodstream, before taking the probiotic. If you have asthma, a probiotic supplement might help – talk to you doctor about this.
Sadja Greenwood, MD, MPH - back issues on this blog. Write me a comment, and I'll answer you.
Friday, June 22, 2012
GMO labeling, the Farm Bill, & anti-cancer herbs and spices
In November we will be voting on a referendum in California requiring that all genetically engineered foods be labeled. If it passes, California will be the first state to require such labeling on packaging. Citizens in Europe, Japan and other countries (almost 50 in all) have access to such knowledge. This is an historic occasion for voters – you should know that companies such as Dow and Monsanto will put up a strong campaign against the referendum, and may sue the state if it passes, as they threatened to do in Vermont, where a legislative bill for labeling did not make it out of committee.
The referendum is important because ‘superweeds’ have developed in response to the herbicide ‘Roundup’ (glyphosate). The result has been heavier spraying of the Roundup Ready corn and soybeans that have been genetically modified to withstand such spraying. About 90% of soybeans and 70% of corn and cotton grown in the US are Roundup Ready crops. Additionally, Dow Chemical has asked for USDA approval of a type of corn that can withstand spraying by 2,4D (a defoliant similar to 2,4T used in Agent Orange in Vietnam war days). Many large-scale farmers in the Midwest approve of Dow’s new crops, saying that resistant weeds have become a crisis and without new chemical approaches, farmers would have to plow more and thereby increase soil erosion. On the other hand, Sweden, Norway and Denmark have banned the use of 2,4D, because of toxicity to workers (central nervous system symptoms, dermatitis, possible long term effects on the children of women exposed in pregnancy, and possible increase in lymphomas). Farmers who do not use GMO crops fear genetic drift from the altered plants’ pollen, and also drift of the herbicides used.
This is clearly a complicated question, and we will hear a great deal about it in the run-up to the November election. Here is another reason to exercise your right to vote!
Th US Senate is currently considering the 2012 Farm Bill. Senator Kirsten Gillibrand (D- NY) is opposing a $4.5 billion cut from food stamps, which will then be opposed in the House of Representatives where a majority of Republicans have said they want deep cuts in food stamps. In addition, she wants to help markets that sell fresh produce in areas where it is not available, and encourage the creation of insurance for specialty crops such as apples and onions. To take action on Gillibrand’s amendment that would restore cuts from nutrition programs and redirect $500 million to healthy food programs, you can call Lynn Woolsey (415-507-9554), Senator Boxer (415-403-0100) and Senator Feinstein (415-393-0707). Senators Bernie Sanders (D-Vermont) and Barbara Boxer ( D-California) have introduced an amendment requiring GMO foods to be labeled nationwide. Call Senator Boxer about this as well, if you agree with such labeling.
I have just returned from a nutrition conference put on by the Center for Mind-Body Medicine. One of the speakers on cancer was Jeanne Wallace, who also spoke here at Commonweal last year with chef Rebecca Katz. Wallace listed the top 10 foods to block angiogenesis – the growth of new blood vessels that encourage cancer growth. They are:
*Spices – especially curry, ginger, garlic, parsley
*Berries – all types
*Green tea
*Parsley, peppermint, thyme
*Curry - turmeric, coriander, cumin
*Garlic
*Brazil nuts – for the selenium
*Cold-water fish/ Grass fed meat - for the omega-3 fatty acids
*Traditional soy foods - edamame, tempeh, tofu, plain soy milk
*Peanuts (boiled), red grapes/wine - resveratrol
I will write more about this conference in future columns. In the meantime, if you eat, be a food activist!
Sadja Greenwood, MD, MPH
The referendum is important because ‘superweeds’ have developed in response to the herbicide ‘Roundup’ (glyphosate). The result has been heavier spraying of the Roundup Ready corn and soybeans that have been genetically modified to withstand such spraying. About 90% of soybeans and 70% of corn and cotton grown in the US are Roundup Ready crops. Additionally, Dow Chemical has asked for USDA approval of a type of corn that can withstand spraying by 2,4D (a defoliant similar to 2,4T used in Agent Orange in Vietnam war days). Many large-scale farmers in the Midwest approve of Dow’s new crops, saying that resistant weeds have become a crisis and without new chemical approaches, farmers would have to plow more and thereby increase soil erosion. On the other hand, Sweden, Norway and Denmark have banned the use of 2,4D, because of toxicity to workers (central nervous system symptoms, dermatitis, possible long term effects on the children of women exposed in pregnancy, and possible increase in lymphomas). Farmers who do not use GMO crops fear genetic drift from the altered plants’ pollen, and also drift of the herbicides used.
This is clearly a complicated question, and we will hear a great deal about it in the run-up to the November election. Here is another reason to exercise your right to vote!
Th US Senate is currently considering the 2012 Farm Bill. Senator Kirsten Gillibrand (D- NY) is opposing a $4.5 billion cut from food stamps, which will then be opposed in the House of Representatives where a majority of Republicans have said they want deep cuts in food stamps. In addition, she wants to help markets that sell fresh produce in areas where it is not available, and encourage the creation of insurance for specialty crops such as apples and onions. To take action on Gillibrand’s amendment that would restore cuts from nutrition programs and redirect $500 million to healthy food programs, you can call Lynn Woolsey (415-507-9554), Senator Boxer (415-403-0100) and Senator Feinstein (415-393-0707). Senators Bernie Sanders (D-Vermont) and Barbara Boxer ( D-California) have introduced an amendment requiring GMO foods to be labeled nationwide. Call Senator Boxer about this as well, if you agree with such labeling.
I have just returned from a nutrition conference put on by the Center for Mind-Body Medicine. One of the speakers on cancer was Jeanne Wallace, who also spoke here at Commonweal last year with chef Rebecca Katz. Wallace listed the top 10 foods to block angiogenesis – the growth of new blood vessels that encourage cancer growth. They are:
*Spices – especially curry, ginger, garlic, parsley
*Berries – all types
*Green tea
*Parsley, peppermint, thyme
*Curry - turmeric, coriander, cumin
*Garlic
*Brazil nuts – for the selenium
*Cold-water fish/ Grass fed meat - for the omega-3 fatty acids
*Traditional soy foods - edamame, tempeh, tofu, plain soy milk
*Peanuts (boiled), red grapes/wine - resveratrol
I will write more about this conference in future columns. In the meantime, if you eat, be a food activist!
Sadja Greenwood, MD, MPH
Monday, June 4, 2012
Update on calcium
Recent reports of an increased risk of heart attack in people taking calcium supplements have been very confusing. For years we have been told to take calcium pills to supplement dietary sources of this mineral. Here’s the evidence so far. Calcium is critical for building and maintaining strong bones and teeth; it also plays a role in muscle contraction, nerve transmission, blood clotting and blood vessel flexibility.
A recent study in the Archives of Internal Medicine looked at 39,000 older women in the Iowa Women’s Health Study, and found a small decreased risk of death among women taking calcium supplements. This contrasts with two studies from the University of Auckland (British Medical Journal, 2010 and 2011) which looked at the U.S. Women’s Health Initiative and found that calcium supplements, with and without vitamin D, modestly increased the risk of a heart attack. The data are difficult to interpret, and more studies and further analysis is needed. A Canadian journal said “if 100 patients take calcium supplements, less than 1 will have a fracture prevented, and less than 1 will develop a heart attack
or stroke.” A small increased risk of kidney stones has also been shown in people taking supplemental calcium, but not with dietary calcium.
The Institute of Medicine concluded in 2010 that adults should get 1000 mg a day of calcium, and post-menopausal women should get 1200 mg. An adequate calcium intake is especially important in pregnancy and breast feeding. Girls ages 9 – 18 often do not get enough calcium in their diets due to a preference for sodas, fake foods and dieting. Supplements of calcium, magnesium and vitamin D as chewable tablets may be beneficial for them, as this is a critical time for bone building.
I conclude that it is vitally important to get enough calcium from our diets, and to use supplemental vitamin D if needed to raise levels of D to 30 ng/ml or higher. Good dietary sources of calcium include low fat milk products (think unsweetened yogurt and cottage cheese and nonfat or 1% milk), green vegetables (especially broccoli, collards, kale & bok choy), almonds, Brazil nuts, sunflower seeds, sesame seeds and dried beans. Calcium fortified soy milk and orange juice can help vegans get enough calcium. Some tofu is high in calcium; read labels to be sure. People with osteoporosis should talk to their doctor or nurse practitioner about the risks and benefits of supplemental calcium.
Studies of men have suggested that a high intake of calcium from dairy products may increase the risk of prostate cancer, but the evidence for this is inconsistent. Men can consider getting a maximum of dietary calcium from non-dairy sources of the mineral.
A 2006 study from the University of Pennsylvania showed that use of proton pump inhibitors (Nexium, Prilosec, Prevacid and others ) to reduce acid reflux is associated with an increased risk of hip fracture in people over 50, probably due to decreased calcium absorption and other mechanisms. Long-term use of these medicines increases the risk. Short term use is often indicated, but many people stay on these anti-reflux drugs for years. These medicines can also increase the risk of pneumonia, vitamin B12 deficiency and low magnesium levels. There are other ways of dealing with acid reflux, including weight loss, avoiding trigger foods and high fat meals, eating frequent small meals, and sleeping in a Lazy-Boy chair or with a wedge pillow if the problem comes on at night.
Here in West Marin are blessed to have local organic dairies that produce wonderful yogurt. Yea for farmers’ markets with their abundance of calcium rich vegetables
Sadja Greenwood, MD, MPH back issues on this blog
.
A recent study in the Archives of Internal Medicine looked at 39,000 older women in the Iowa Women’s Health Study, and found a small decreased risk of death among women taking calcium supplements. This contrasts with two studies from the University of Auckland (British Medical Journal, 2010 and 2011) which looked at the U.S. Women’s Health Initiative and found that calcium supplements, with and without vitamin D, modestly increased the risk of a heart attack. The data are difficult to interpret, and more studies and further analysis is needed. A Canadian journal said “if 100 patients take calcium supplements, less than 1 will have a fracture prevented, and less than 1 will develop a heart attack
or stroke.” A small increased risk of kidney stones has also been shown in people taking supplemental calcium, but not with dietary calcium.
The Institute of Medicine concluded in 2010 that adults should get 1000 mg a day of calcium, and post-menopausal women should get 1200 mg. An adequate calcium intake is especially important in pregnancy and breast feeding. Girls ages 9 – 18 often do not get enough calcium in their diets due to a preference for sodas, fake foods and dieting. Supplements of calcium, magnesium and vitamin D as chewable tablets may be beneficial for them, as this is a critical time for bone building.
I conclude that it is vitally important to get enough calcium from our diets, and to use supplemental vitamin D if needed to raise levels of D to 30 ng/ml or higher. Good dietary sources of calcium include low fat milk products (think unsweetened yogurt and cottage cheese and nonfat or 1% milk), green vegetables (especially broccoli, collards, kale & bok choy), almonds, Brazil nuts, sunflower seeds, sesame seeds and dried beans. Calcium fortified soy milk and orange juice can help vegans get enough calcium. Some tofu is high in calcium; read labels to be sure. People with osteoporosis should talk to their doctor or nurse practitioner about the risks and benefits of supplemental calcium.
Studies of men have suggested that a high intake of calcium from dairy products may increase the risk of prostate cancer, but the evidence for this is inconsistent. Men can consider getting a maximum of dietary calcium from non-dairy sources of the mineral.
A 2006 study from the University of Pennsylvania showed that use of proton pump inhibitors (Nexium, Prilosec, Prevacid and others ) to reduce acid reflux is associated with an increased risk of hip fracture in people over 50, probably due to decreased calcium absorption and other mechanisms. Long-term use of these medicines increases the risk. Short term use is often indicated, but many people stay on these anti-reflux drugs for years. These medicines can also increase the risk of pneumonia, vitamin B12 deficiency and low magnesium levels. There are other ways of dealing with acid reflux, including weight loss, avoiding trigger foods and high fat meals, eating frequent small meals, and sleeping in a Lazy-Boy chair or with a wedge pillow if the problem comes on at night.
Here in West Marin are blessed to have local organic dairies that produce wonderful yogurt. Yea for farmers’ markets with their abundance of calcium rich vegetables
Sadja Greenwood, MD, MPH back issues on this blog
.
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